Pati cakes

Hard to believe that Patagonia is one year old already. Pati is the first one of the kids to suck her thumb. She finds her blanket very comforting. She likes to snuggle and she likes Daddy best of anybody. All the older kids want to take care of her and carry her and make sure she is OK. Sometimes it bothers her and I think she learned to walk at 10 months out of self defense. If she wasn't so big I think Anne would carry her around just like Alec and Jan do.
She fell down the basement stairs in November. I was at the bottom and I heard a sound like a cat yowling and poor Pati was bouncing her way down. I stopped her a couple of steps from the bottom. She had bruises but that was all. Scared us both. David installed a hinge on the basement door that makes it close unless it is propped open by something heavy.
Pati is a good sleeper and has never been the demanding sort. She is patient and waits her turn without much fuss. She is stong willed in a quieter way, so that it is easier to miss. I was especially grateful for an easy going baby last year since we dealt with so much sickness.
She does her best to keep up with the older kids and even goes outside to play in the snow with them. They love her and try to take good care of her...although sometimes she would do better on her own!
Pati missed being a Christmas baby by just two days. My Grandpa and his Father were both born on Christmas, but we were happy with the 27th. David's Aunt Bee and another of my Great Grandfathers were born on the 27th. That day was the first day that month that David was available to be there for the birth, so I was happy that she came on the 27th. We missed having Heather Judson here for Christmas since she came last year for Pati's birth.
David got to be home this year too on Patagonia's birthday and we had a little tiny party.

Thanksgiving

This is just somewhere we want to go someday. Wonder if we will make it there.
Several years ago I read a book that encouraged me to be occupied with Christ. To think of Him as my occupation. I liked the picture that it left me with. I wanted to be occupied with Christ. I still want that.
David talked to me recently (he makes it home once in awhile)about walking with God through the day, and how important it is to mentally walk with Him, take things to Him, be with Him.
Somehow the reality often is that I lose sight of that and just see the laundry, the diapers, the mess, the barfs, another weekend alone (alone with four children...does that count?)and I forget to share it with Him.
I want to walk with God all day long.
We made pies and jello today and the kids and I are looking forward to Thanksgiving breakfast tomorrow cause we are going to have pies and jello. Jan and Alec have started helping out in the dishes department and I think it is wonderful. David comes home around lunchtime tomorrow to get some sleep and then we will do what we can to wake him up around dinnertime for pies and jello.

Is October in the Fall?

From October 2007

Well, we are nearly past the summer, but you wouldn't know it. The weather is still in the 70's, seems like we just started school again, and we have more trauma patients than normal on the trauma service here at work.
As I knock on some substance that appears to be related to a tree, I marvel that the Carne family has not made it to the Emergency Department for some time in the patient capacity. We have been riding bikes, hiking, swimming, playing baseball and Frisbee and learning all sorts of new things in our home school time. Kristi went out west for a wedding of a dear friend, and promptly contracted the west coast flue virus, or whatever it was, and was ill enough to have to postpone a return flight to recover. We had expert help back here on the homefront, in the form of Mary Beth Copper, so all was well. Was nice to have her here and the kids shed many a tear when she left to go back to Washington.
Jan has been growing up, looks much more like a big girl now, and is reasoning and asking questions enough to get responses from the parents like "can you please just be quiet for a while, or read a book, or draw a picture, or go play outside?" She is curious about most everything and wants to know exactly who is calling, what they are saying, what socks they are wearing, etc... She is excelling at school work, and says "did you know I would be so good at art?"
Alec is getting much older. Connects with a baseball quite well, throws a frisbee like a champ, and is a pretty protective brother for all of his girls. He is pretty quick to pick things up, and is quite sensitive to negative waves. Very helpful and likes to do boy stuff with dad, especially if it includes tools or fixing things.
Anne is still rashy below the knees, but much better than she was. Still fights gravity without much success, and is the most radiant sunshine or the most gloomy cloud. She is quite verbose and continually astounds me with her vocabulary and grasp of the events around her. The Chiropractor the other day was treating her a little younger than she likes and commented about her top "this is red, isn't it?" To which she quickly replied with a finger on her pant leg "this is blue, isn't it?"
Pati has to be one of the best babies, and I think weighs more than Anne does, or nearly so. She is standing by herself now (10 months) and is not fond of any form of correction, but seems to persist in getting it. She appears to have a good sense of humor, and laughs heartily.

Work has been very busy lately. I am on the Trauma team this month, and it has been the most busy month all year, by far. We have had about 40 trauma patients over the past 6 days, which accounts for over 15% of our yearly number. Lots of car wrecks. Lots of drunken people. Some of our own residents. That new sport of Hood Surfing seems to be catching on... Or maybe it is a new effect of lots of alcohol and cocaine together. Who knows, but usually you lose. Maybe that is not fair, as I am not sure how many people are actually out there hood surfing and I am only seeing the losers.

Okay, I will end for now. Have to go back to Call duties. I have discovered Facebook and have been experimenting. Not sure if I like it yet or not.

David

Hiking Spree

We missed it last year but found out what all the signs for "Fall Hiking Spree" mean in time to complete it this year. Every year the Metro Parks here in our county put out a list of hikes. If you hike eight of those on the list you earn a hiking stick and the current years spree badge. After you earn your stick each year you finish the hikes in the months September-November you earn a new spree badge. The old-timers around here hike in the fall with their hiking sticks sporting 10 to 20 badges. Now we know what they mean and both Jan and Alec are impressed when they see them. I am sure that they have visions of showing off their own sticks plastered with badges someday, but for now they are proud as can be to hike with their sticks and the single white badge that they earned. All six of us earned hiking sticks and hope to use them for several more hikes this fall before the snow starts to fly here. Jan and Alec hiked every mile on their own. Anne didn't. But she is working on it and next year she will probably make it without help. Since Pati isn't quite walking it might be a couple years before she can keep up.

Family Fun

David was home for the night. The temperature was perfect after a long run of stifling humidity. We braved what Alec calls "aggressive bees" and had a picnic at Stan Hywet. It was fun and we stayed for awhile and explored the grounds.

Mommy tip

I guess it would be a tip for anyone caring for children. I discovered it in a time of desperation and it is forever burned into my memory as one of my most brilliant moments. The only audience was my four children and only one of them noticed; not Pati grinning in the stroller or Alec worrying about getting to push the elevator button once we got back to the elevator or Anne touching everything in the bathroom she shouldn't - just Jan, sick as a dog.
If you are ever in a public place and need something portable and disposable to catch any kind of mess, just look under the garbage bag in the rest room. They keep whole rolls of extra garbage bags. Tear one off the roll and you have a portable throw up bowl or whatever. I had to do it twice from two different bathrooms as we were caught in a large office building with an appointment to keep and Jan was suddenly very nauseated. And I knew exactly what she had had for breakfast. Alot.

Summertime

From July 2007

Some time now has passed by since I last put anything down here for people to peruse. I always have liked the sound of that word, just been a while since I have been able to do it or use it.
Since I last wrote something down, Kristi, Alec, and Anne have all celebrated birthdays. We have four new fangs in Pati's mouth, the northwest has been blessed with our presence as we returned for a family reunion and wedding anniversary, and because some of our wonderful family paid the way for us to go. We had a great time out there and it felt like a real summer to be able to spend time with family, play frisbee and eat watermelon.

On the work front, I have been doing the upgraded duties and schedule of a second-year resident, which includes lots more work when I am on call, and I am on call much more, or so it seems. Now a days, I am quite proficient at putting in central venous catheters, thoracostomy tubes, and just last week I removed my first gallbladder as the operator (not the assistant), which means from start to finish I did the entire case myself. Most likely doesn't mean all that much to you, because you can't appreciate the difference, and in a year or so I suppose it won't mean much to me either, as I will be doing that more than assisting, but for now it is a pretty big milestone in my mind.
We have also enjoyed relative good health this summer, with only some fevers and minor illnesses to account for. Jan is getting quite old it seems, and is more of a help to mom than ever. She is much more interested in school things, and even writes "cursive," and I think by the looks of her "writing" she may have some medical potential there.
Alec is now without training wheels, is still working on his "R's," and "L'S" because they both come out "W" still. He is getting to be a help to mom as well, and is pretty interested in "boy" stuff.
Anne is the life of the party, and alternates from being the most entertaining and sweet child to a real challenge if she is crossed or corrected and doesn't appreciate it. She has quite the wit and vocabulary, and uses both prolifically. Her eczema is much more controlled now that she is on the strict and rotating diet, and I think it just might work for Anne's health, but not for Kristi's mental health. I am not sure how she manages to keep a home, raise a family, and see to the needs of a husband like she does. She is amazing and I know she has the hard end of this deal for sure. She has stuck with me though, and still says she loves me, so I guess it is worth it. I am so grateful to have her, and could not do this residency thing without her.

At work we have been dealing with all of the greatest members of society, who seem to save up their tricks and fancy moves for when they are drunk and tired. I think working on the trauma service is sort of like a box of chocolates, "cause you never know what you will get next." Usually one common denominator is alcohol, and a very low I.Q., which may be redundant as I am not really sure which one comes first.
Some of the more interesting cases lately have been those that I had a "strange feeling about." It is the not very scientific part of medicine, and I seem to recall a book I had started reading with Kristi called "Blink." There are these cases I get where I get one story, and then things just don't feel right, so I start following my sense of what isn't right and have ended up with some bad stuff. The first one was a couple of weeks ago, when I was called to go evaluate a patient who had just completed open heart surgery 4 days prior to my seeing him. His abdomen was distended and he was breathing sort of fast and shallow, and just didn't look right, but he refused to acknowledge anything going on, or any real pain.
I didn't believe him and went to look at the CT scan he just had that the radiologist read as "negative." I stared at it and something just didn't seem right, so I played around with it for a while and then started to see some air that wasn't in his bowels. This means you have ruptured a hole in the bowel somewhere between stem and stern, so I showed it to my attending, and told him my concerns. He agreed with my analysis that something was up, and so we went down to radiology to have them explain to us how this gas was read initially as not outside of the bowel... Anyhow to make a long story short, he had ruptured his colon and we had caught it early enough to hopefully catch him before he got really sick.
The next case was a lady who came into the emergency room looking like she was going to die, pale, sweaty, heart rate fast, and writhing in pain. The emergency room told me they thought she had a ruptured aneurysm, or at least a dissecting one, and when they sent her to the CT scanner, told me they were going to call me about her. I was curious, so I went down and watched her CT scan, and her Aorta was fine, but her bowel looked goofy to me. The radiologist told me that she was just breathing too much and the CT was too poor quality to make any diagnosis, but he didn't think anything was wrong. I disagreed, and went and showed it to my attending who was in surgery at the time. He went on my intuition and scheduled her for the OR. I was starting to feel like maybe I would look really stupid if he opened her up and didn't find anything, so I started second-guessing myself, especially since she was much more comfortable with the pain medication on board. To shorten it up again, we decided to go to surgery anyway, based on my bad vibes, and the attending called me into the OR 45 minutes later. I was thinking, "here it comes, I am going to get reemed out for making him operate on a perfectly normal and healthy lady." As I walked in the door, I could smell this unmistakeable smell of death, and looked on the table and he says, "you think we should have operated?" "I guess so," as I look at 3 feet of dead small bowel sticking out of her belly. Normal small bowel is pink. Dead small bowel is very dark red/black color. She had an internal hernia of her small bowel and it strangulated the blood supply, killing off a loop of her bowel.

Well, enough of the stories for now. I have to run study for my board exam next week, see Alec's new bike kickstand and bell, and put the kids to bed.

Take care and write if you get a chance to tell me how you are doing.

David

Summer's end

July flew by and August is almost gone too. I hate to see it go, I have always loved the summertime. Tonight the kids thought that I had let them stay up REALLY late since it was actually dark when they got into bed.
David was able to take a week of vacation time in July and we flew to Oregon for a trip that was just too short. Wow we saw alot of relatives! It was a good time of reconnecting with people and letting the kids reconnect with cousins. We sure miss everyone out there. Going "home" was like a breath of fresh air for me, I loved it. It was good to come to our real home, though, and swing back into real life here.
For over a month we owned our very first family pets. Goldfish. It was fun while it lasted. Several wading pools in town release 400 goldfish into their pool one day midsummer(it is when they are refilling the pool, before chemicals go in) and let kids try to catch them in a container and take them home. It was FUN and we came home with four fish. Every morning we would make our way to the breakfast table, wondering if the fish would be swimming around or floating upside down. Each one was carried outside on a slotted spoon and buried in the flowerbed. Two of them have crosses. Alec dug his up several days later and reburied it...just curious I guess.
The kids have been "building stuff" out in the yard. We brought home a carload of free lumber scraps from Home Depot and Jan and Alec built a bike jump (with some help), some boats to float in their plastic pool and some other stuff. Most of their spare moments have been spent outside hammering this last week (Anne too).
The kids and I have been driving out to Wadsworth every weekday for the last two weeks for swimming lessons. (It is just a twenty-five minute drive, but somehow, here, the way people think of it is "driving ALL the way out to Wadsworth".) Jan is really swimming, and Alec is just starting to paddle around too. The first week we went out we missed three days because of thunderstorms (Humidity! That whole week I felt as though we were living in a bathroom while someone was taking a shower). We have two make up lessons this week for the days the pool was out of commission because it was directly hit by lightning. Now, when the kids are out playing in the plastic pool in the backyard Jan hustles everybody out at the least hint of thunderstorm. She takes such good care of everybody.
That was the week we had our first tornado warning, too.
All of the sudden everyone is talking about school starting and fall coming. For some reason I just am not ready for summer to be over yet. All of that canning that I didn't get done, the planning for school that I have yet to do. I work really hard and never seem to get it all done...but I do take lots of breaks to race kids around the house (they make a mark for every trip around the house...Jan is winning right now) laugh over their funny books from the library and set the chipmunk traps, and get out junk so they can do projects and do all of the things that never make it onto my to do list but they are the only things that we remember when the day is over.
On the other hand, it is good to see time passing since that means progressing through residency. Right now just checking off one more day of it is good! No matter how hard David works he never gets it all done either.

"For we are His workmanship, created in Christ Jesus for good works which God prepared beforehand that we should walk in them." Ephesians 2

Chipmunks

This spring we were overrun with chipmunks. They were everywhere all of the time. Squirrels too, but the chipmunks caused trouble. Digging holes in the grass, eating things in the flower beds, getting into the garage and just generally messing with things. After trying several "humane" things our neighbors bought rat traps.
Grandpa and Grandma Copper came out to visit (and Uncle Titus and Aunt Kaytra, along with cousins Elise and Triana Engen). My Dad bought the kids a chipmunk trap. They were in heaven. They learned that you have to put the bait on a scoop of peanut butter so that the chipmunks can't just take the bait and escape before the doors close. For days that was the most exciting thing happening here. Usually when Jan and Alec or Anne wakes up in the morning they come to see me (makes me feel important). Not when the traps were set. I would hear noise from their bedroom and stumbling out in the hallway, and they would run right by my room and out the front door to see if they had caught anything. I think that the final count was 18. Some days they caught 4 or 5. Alec and Grandpa Copper would load them into the car and give them their freedom at the golf course a little way down the road. They caught a few squirrels when the chipmunk trapping slowed down. One of the last nights they set the traps we watched a skunk with a long flowing tail prance through our backyard. We all hoped that skunks didn't like peanut butter.
At the beginning of June we got the results back for a blood test that Anne had taken. We have been careful with diet but unable to pin down all of her food sensitivities without a blood test. She had been tested for IgE reactions last fall and showed an allergy to rice. I had removed rice and milk and eggs and oats and chocolate and citrus and tomatoes and I don't know what else. She improved but still wasn't doing well. She flared up badly this spring, awful eczema, 7-8 poopy diapers a day, some in the middle of the night, nearly always woke up poopy or so wet her bed was wet too. Her bottom was orange (like a burn) and often raw. She was crabby and cried alot, her nose was usually runny. She was up nearly every night, usually 2 and 3 times crying and itching or crying and pooping. God provided the money to take a different blood test, a test for IgG reactions to 115 different foods. It came back positive for 26 more things. She is on a very limited 4 day rotational diet and has slept through the night for two weeks now. Her orange bottom is gone and she has a much better disposition. The only gluten containing food that she didn't react to was rye but when I gave it to her on her "rye day" she had an awful reaction to it and although she had not been tested for gluten sensitivity, at this point I think that it is a likely possibility. I am trying to be diligent to really rotate her foods and am grateful for the improvement in the last two weeks. (Enjoying the break in the diaper department as well, since she is down to 2 or 3 times a day.)That may be a boring update for some but it is something that has been a "big deal" for us and it continues to be. She is a good sport, eating steamed cold cauliflower when other kids are eating goldfish crackers. She has learned to say "I don't like it!", but she will eat it anyway.
After a comparatively good two weeks as far as schedule goes David is back on yucky schedule. I guess there is a reason that they call them "residents". We won't see him much for the next three weeks but then we do get him for a week of vacation which we are all excited about. He has to take another nasty test in July or August which means that he will spend most all of his "free" time between now and then studying for it. All I can say is that David is a diligent man who works hard and does what he can to keep a good perspective about where the Lord has him. "They" say that all surgical residents seriously consider quitting during years two and three. I am beginning to understand why and I don't even go to the hospital. I just see the demands put on him in terms of time and energy and am proud of all that he does. He took the kids to the ball field last night and pitched so that we all could bat and run the bases (Alec had bought a pair of baseball cleats at a garage sale and really needed to try them out).
Looking forward to seeing some family and friends in the few days that we will be in Oregon.
Kristi

dinner conversation

David had a pretty good schedule at the beginning of this month. The bad thing about a good schedule, I am finding, is that you always end up paying for it. Since he had his four days off in the first two weeks of May that means that he has no days off for the rest of the month...it also means that he is working Memorial Day weekend. David's job has given me a whole new view of holidays. They are beginning to mean "days when people drink alcohol and do stupid things and either end up in the hospital or putting other people in the hospital". It does make for interesting dinner conversation. David was on call on Friday which means that out of Friday and Saturday we got to see him for about three hours. At dinner, we heard about the man who took a nasty fall and broke some facial bones and has been leaking fluid from his brain out of...somewhere (his nose I think). Then there was the man who got shot and David spent two hours up to his elbows inside the man's belly, squeezing his aorta, while two other surgeons searched for the source(s) of all the bleeding. I asked "How did you know it was his aorta, how did you find it?" He told me how to find it, although I hope I never have to do it. I don't remember what we had for dinner but I was glad it wasn't spagetti. (I guess there are some good things about Anne being allergic to tomato sauce.)I had been considering telling him about some of my day, but it all seemed so trivial after that. None of what I do is anywhere near as intimidating as what happens to him on a regular basis.
Today is Sunday and David is on call again which means that out of today and tomorrow we will see him for an hour or two tomorrow. He managed a 60 second phone call from the hospital at 10:00 tonight - I guess he had a few second lull while a woman who came in as a trauma patient was in the CT scanner. I was baking a chocolate cake and mixing up pretzel jello for the neighborhood picnic tomorrow. So, David is spending the weekend putting in central lines, IV's and chest tubes and I am changing diapers, giving baths, saving kids when Anne poops in the bathtub again, scrubbing, cooking, folding, making funny face sandwhiches, feeding a baby, breaking up fights, figuring out what in the world I can feed Anne that is wheat, dairy, rice, tomato, chocolate and citrus free and admiring craft papers.
I like my job. The kids and I have a pretty good time together most days. Any time David has a day off we call it vacation and it is the best time of the month. I am looking forward to tomorrow and hearing more of his stories at supper. When my Mom was here last month I got to go down to the hospital one of the nights he was on call and meet him for an hour. David went up to put an IV in someone and I got to go and watch. It was the first time I have ever been with him while he is working at the hospital. I honestly cannot imagine what surgery must be like. Maybe someday I will get to go and watch, but for now I guess I will be content with hearing about some of it.
Kristi

May Flowers

We have had our fair share of flowers here, finally. What they say about April is all true, it really is the cruelest month. We had snow on Easter, something I don't remember in the story books, although the bunny is always white, so maybe an Arctic Hare?

Life had been busy for us here in Akron. Spring has brought outside activities that include lawn care, garage cleaning, mowing the lawn, searching in vain for our little wading pool that blew away, emptying the lawn mower bag, playing with toads and riding our bikes as much as possible. As soon as it hit 60 degrees, the kids managed to get us to set up the slip-n-slide. I guess that winter coat is pretty thick still.
Jan is riding her bike without training wheels, and is able to keep pace with the runners on flat terrain. Alec is starting to think about riding without the training wheels on, but is not quite there yet. His asthma seems to be better controlled at the moment. Anne is still getting into all sorts of trouble, stirring up trouble, and just plain trouble whenever she is not being a very delightful child, which is most of the time. Pati has been the best baby ever, smiles even when sick, and lights up with a huge smile with any drop of attention.

We have been to the Cleveland Botanical Gardens most recently, which was great fun. We get in free with our pass to a local historic mansion site here in Akron, so that was why we were able to enjoy it. They even had a small children's garden where volunteers help keep the kids focused, hand our free trees that dad gets to plant when we get home, and a large indoor section including a rain forest with lots of butterflies, and an arid region with lizards and hedgehogs and such. Quite well-done and we all had fun there.

That wasn't enough for us, so we went to the Cleveland Zoo and had lunch with the elephants again. Pretty fun to be able to be so close to so many zoos and parks and activities. That is the nice thing about this area; we are close to everything. Within a 2-hr drive we have 5 nice zoos, 2.5 aquariums, 3 science centers (OMSI type), Lake Erie, the world's largest roller coaster park and lots of indoor and outdoor waterparks (some day later we will discover these), and countless metroparks that are usable year-round.

We also are becoming a bit more involved in Church. Kristi and I have been attending a series of weekend classes on how to study the Bible and communicate effectively (Hermeneutics and Homiletics). I most likely butchered the spelling there. Has been good, and we seem to be fitting in a bit more as well. Is tough to get involved when I am not there much, but I think we are doing a bit better.

Well, I have nothing more to add, seeing how I am here in the ICU on call at 3:30 am waiting for a CT scan to be done on a lady who has a bleed in her brain.

Drop us an email if you feel like it, or drop by if you can.

David

"April is the cruelest month"

I never understood that quote before but I think that it is coming to me now. The first week in April we had a couple of days in the 70's. It was great! Jan learned to ride without training wheels. Everybody graduated to the next size up in bikes (Alec to Jan's, Anne to Alec's old scooter from last year, and Jan actually downgraded because it is less intimidating to ride without training wheels on a smaller bike). We got out the plastic pool and wore swimming suits for a couple of days. Then the snow came back. We are back inside eating soup again.
David had to work a few hours in the morning Easter Sunday and then had a week of vacation which we all thoroughly enjoyed. We are squeezing every last drop out of our Akron Zoo pass. On Monday we made our way to Pittsburgh and used our pass to visit the zoo and aquarium there. It was too cold to be outside much but the aquarium was so much fun. On Wednesday we headed to Erie, PA, mostly to see Presque Isle State Park. We played for awhile in the sand, built a fort out of driftwood and when it got too cold for us we drove over to use our pass at the Erie Zoo. David and I thought the best plan for the week would be to go and do something every other day and rest on the in between days. On Friday we had run out of (zoos?) ideas. I asked Jan and Alec what they wanted to do. "Stay home." "How bout we wrestle with Dad after dinner?" Sounded good to us. Almost every night Alec asked "When will we see Dad again?" It was fun to be able to say "Tomorrow" for so many days in a row.
David is back at work today for a 30 hour shift but at least for this one he is rested up. The pastor of the church we are attending here has been giving a hermaneutics class. David went to the first class post call, after he had been up all night. He actually was able to get some good things out of it (didn't fall asleep) and fill me in on the details when he got home. He sent me to the class this week. It was strange. I don't know how long it has been since I sat somewhere alone for three hours (OK so I did have to take a break to feed the baby) drinking coffee, eating doughnuts and listening to a preacher. It was terrific! We have some assignments to work on for the next class (hoping that one of us can make it) but it is three weeks away so we have some time. It was nice to have the opportunity to get some good input and encouragment to be in the Word. (The doughnuts were fun too!)
We were all going through David withdrawals today and can't wait to see him tomorrow. What a good vacation.

March Calm before the storm

Well, I am still employed. At least I think I am, because the government is taking some of their money back, but I guess that is not necessarily indicative of employment. This is the first year I really had to think about taxes, and I discovered yet another benefit from having a family, or make that benefits. Seems like they should list it as beneficiary or something positive. I had a hard time finding where I take credit for feeding so many mouths because they list them as dependents... Seems like they could just call them parasites, or leeches, or something like that. Why couldn't they have you multiply the number of blessings in your life by that number, since for you they are blessings on the tax form, if not at other times and places... I suppose the tax people make those forms, and so for them it is a negative thing for you to be able to have more of the money you are paid for working or doing whatever you do.

I had fun the past week filling out Oregon, Ohio, and Federal returns... so, if anyone has any questions feel free to consult your local tax person because I am needing to take a week straight of call to recover from the trauma of reading through all three instructions books, and filling in and re-filling in the forms for each entity.
The way it worked, the feds didn't get anything because my man W helped me out with that Child Tax Credit, but I guess the states don't see kids as a credit, only a deduction, and a pretty wimpy one at that, so I ended up paying tax in Oregon and then Ohio taxes the Oregon income as well, only giving you partial credit for having paid Oregon tax... Pretty sneaky, I think. Seems like if someone could figure out how to work the system in the private world that the tax people have going, they would rule the world.

Well, the point to telling you all about this is that I actually have time to do my own taxes, given the fact that I am passing gas. That means I am on anesthesia, where we gas our patients into anesthetic states so the "real" docs can operate on them. Obviously, I am only taking this shot at them because they have the best possible job on the planet, except for the malpractice, and this month I see what I would have gone into had I been led to enter medicine to make lots of money and work few hours, having minimal patient contact and no office. Too bad the Lord didn't lead me into the promised land of anesthesia... don't think I haven't been asking lots for a re-assignment this month, and thinking about switching. Oh well, better to be doing what you are supposed to do, right? Right!

At least that is what I have been getting from 2 Corinthians lately, such a good book for me at this stage, seems to hit me over the head with what I should be doing, thinking and acting like. Oh yeah, I am an ambassador of God's righteousness. Seems so hard when that nasty thing called daily life gets to me.

This month, Jan turned 5 and we had a wonderful party here with a few neighbors, friends, and more friends. Anne is recovering from splitting her head open, and we are treating the scar to help it be small as possible... She continues to taunt gravity and pay the price on a near daily basis. Alec is struggling with allergies, his inhaler irritating his intraocular pressures, and letting things get to him when he doesn't feel so well (that last part is me too, by the way), but overall is a great guy and is very helpful. Pati is stuffed up yet again, but the airway diameter is much larger now, so the snot doesn't cause too many problems we can't handle at home. Kristi is recovering from Pati, and is fairly busy -- Okay, really busy with the kids, the house, the home, the husband, lack of the husband, and has even gotten out for a quick jog since the weather has warmed up this past week to melt our snow.
Today, I am home early because I don't feel great (congested), there weren't very many interesting cases I wanted to pass gas on, and nobody seems to care if I am gone. Kristi is gone to Amish country with her sister Cori, who is here for a week with her baby Sonja from Seattle. I even got to spend some quality time with Sonja yesterday afternoon, but I realized three things; Sonja has just entered the age of awareness, Sonja prefers her mother to her scary uncle, Sonja will not accept a substitute for her mother, especially not the scary uncle. Is fun to have them here, and makes us feel not so far away.
Overall, we have been greatly blessed as a family, and have survived almost another year of marriage (6 years on the 24th of this month), 3/4 of a year as a surgery resident, Ohio winter #1 with only one furnace malfunction where the father smoked the house trying to keep his family warm, a flooded basement, emergency rooms and hospital stays (outside of work), tax season, and being without our family and friends from home being within a few hours drive. We have had lots of help and support from you all, in prayers, finances, tax advice, visits with lots of help with kids and projects, and making us feel important in your lives by communicating with us.
Thanks.

Now, I begin a much more intense phase of work next month that will likely stretch through until I finish residency about 4 years from now... I move up in the on-call responsibility and for the next two years will be "taking second call" which means much more responsibility, work, hours, calls per month (as there are only 4 second call people, so you do the math, esp when anyone is on vacation) and stress... I do still hang my faith on the reliability of God and this being His idea anyway. I have His word that He will be with us through this and glorify himself through all of this, so I am sure it will be and has been worth it.

Feel free to write, call, come out, or whatever else you want to do that involves us and you and food. We'll bring the diapers and wipes.

David

And there's the scar

It really looks much better than that by now, I just thought I would put this up since the post about her accident didn't have a picture with it. She hasn't stopped climbing on chairs and tables and couches and counters, but she isn't falling quite as much as before.

Springtime?

While I was putting the kids to bed I was cold. We keep our house at a refreshing temperature so I just thought that I should put on another sweatshirt. After an hour I was really cold, so I looked at the thermostat and it said 60. That is a little chilly even for us. This was a night that David was able to give me a call from the hospital so I asked him for tips on how to get the furnace started again. They were good ideas but none of them worked. I trekked down to the basement and drug out all of the feather quilts and heavy blankets that we had and draped them over the kids, covered Pati up carefully and then we all had a good nights sleep. When we woke up it was 50 degrees inside. We had a fresh 6 inches of snow outside and it was about 17 degrees. Everyone looked so cute with little red noses and rosy cheeks. We drank hot tea, put on snow hats and all swaddled up in blankets on the couch. David got home and built a fire (we had enough firewood for one fire, but we had not used the fireplace yet and I wasn't brave enough to risk a chimney on fire or a smokefilled house). The house warmed up a little and by about 2:00 the furnace was fixed and working just fine.
Maybe today it is a little too warm in here because the kids have been begging to go outside all morning. I finally let them when they finished chores and it got into the 20's outside. I am ready for spring but it keeps snowing! The kids don't seem tired of it, they are inside now eating yet another bowl of snow with honey on it. I feel like I should put up another Christmas tree.

Sundays

Not sure of why all of the medical emergencies in our family happen on Sundays...even better, Sundays when David is on call. Poor Alec spent the entire morning in a collared shirt and tie and we never made it to church. While I was feeding the baby the three bigger kids made their way into the kitchen to wait for breakfast. I soon heard the customary crash of Anne falling. This is a common daily occurance. Somewhere in the area of 5 to 15 times a day Anne falls...from chairs, tables, couches, and then there are the falls because of pushy siblings, slippery socks and some just plain old for no apparent reason. She always yells as though she is dying (Many women swear that they can tell the difference between their childrens mad, hurt, scared and whining cries. With Anne I have given up trying to interpret them. They all sound the same.). I left Pati screaming indignantly in the bedroom and went to check it out since Jan and Alec were yelling about blood. This morning was a little different - she really had hurt herself and there was blood "all over" the kitchen. It always surprises me how much little cuts in the head bleed. When we got it all cleaned up the wound had shrunk down to a generous inch on her forhead...below the hairline. I thought that I would be traipsing back to the emergency room since the gash was pretty deep and looked to be too wide for the super glue treatment (Which I couldn't do by myself anyway...Anne is a wiggler even when she isn't in pain). There are several Doctors that attend the church that we attend - I tried "my" Doctor first (David). He answered my page but was awfully busy and it looked as though I should only use him if I was completely out of other options. I called the doctor that the kids call "Mr. Steve" who lives right down the street and is married to another doctor who the kids call "Mrs. Heather". They weren't home. I had one other option - the doctor who the kids call "Megan's Dad". He was home and graciously gave up a good portion of the morning to put some stitches in Anne's head.
It has been snowing hard all morning but we may venture outside later to break icicles off of the gutters. We already did this yesterday and stored some away in the freezer, but there is a fresh crop this morning and opening the front door is hazardous because it makes ice daggers come crashing down. I think that it distresses the gutters too.
There is so much snow outside that we have a snowman (he really is an icelumpman since the only way to get snow to pack is to build mounds and pour water over it) and a killer snow fort in the front yard - this last week we built two sledding hills in the back yard and are working on an igloo (although I forgot to pour water over that so it is not ready for excavation yet). People don't expect any sign of spring until April.
If there are no other emergencies maybe we will try to make it to night church this evening.

The big storm

Today I was glad for 4-wheel drive. We were hit with about 16 inches of new snow on top of the 12 that were already there. I had fun off-roading it in the big rig at 5 this am as I zipped past all of the honda civics in the world who were trying to swim down the street. Due to the heavy weather, school and most government offices were closed, doctors and patients cancelled surgery, and that all added up to a fairly light day of work, meaning my senior resident sent me home around 1pm when I got my work all done.

Took the kids sledding at our local park, but due to the heavy snow they were having a very difficult time walking back up the hill, so we just made a few passes and called it quits.
Tried my hand at converting video off from the day and have posted it on google for all the world to see.

http://video.google.com/videoplay?docid=4260019235756321422&pr=goog-sl

If that doesn't work, you can email me and I will send you the link.

I am now going to be on call for a good stretch, so I may be quiet until March.

Getting to do lots more surgery, and getting to be quite the seamstress.

More later.

David

Frozen February

Winter is here, finally. After a December with nere a flake of snow, and a January where it rained as much as it was cold, we now have some winter weather. We have about 4 inches of snow on the ground, that blows around, and for the next 3-4 days it is forcasted to be well below 20 degrees F.
We now have carpet picked out for the office downstairs, someone to come out next week for to tear up our bathroom (they laid linoleum down on top of carpet and now it stinks and will come up) and put down some new linoleum. So, maybe next weekend I will be able to put the office back together and have a place to hide and study and pay bills and such.

From January 07

While we were at Home Depot picking out carpet last night, the lady in the carpet section told us that Home Depot has a craft day every Saturday from 9-11:45, so I took the three older kids to Home Depot and we put together race cars, visited their bathroom, and then made it out of there, but not before they hooked me with their discounted snow sleds. Jan wanted the Red one, and was nearly in tears when I said "no." She got over it. Alec really wanted the Orange one and was in tears because he said "I don't know how to use the other one." Actually, he doesn't know how to use any of them, but he got over the answer I gave Jan just a few seconds earlier.
I got the fancy one that looks like a wakeboard, and we went to the park just past our house, where there is a sledding hill. Actually, it is a pretty nice sledding hill, and is sort of like a bowl, so they sled down and then sort of slide around in the bottow until friction overtakes gravity, or big slow kid doesn't get out of the way fast enough. I decided to take them down with me, and that worked well until about 3 times into it Jan says to me, "can I go by myself?" I started to say no, but I thought about that turtle Crush on Finding Nemo who says "it's time to see how Squirt does flying solo," and I said "uh, sure."
After some instruction which mostly included repetitions of "hand on tight" in various flavors, Squirt flew solo, and actually did very well, except I forgot to tell her not to walk back up the middle of the hill, where everyone else slides down. Oh well, that's how you learn, I guess. Next, Alec wanted to go down by himself too, and so both Squirts did very well flying solo. So much so that by the end of the time I decided to add some speed and put them on together. I almost bowled a perfect strike, where they nearly took out a pack of about 8 14-year old girls at the bottom, who were talking and joking until Jan and Alec came blasting through the pack.
We will have to go back and bowl again, and maybe I will bring my camera, so I can share it with you all.
At many of these parks here, there are ponds that are converted into ice rinks... Which we decided maybe we will plan on doing next year, after a year of solid shopping for ice skates for the family. I had some old russian hockey skates, but gave them up a while back. Actually, we could most likely find some skates quite easily, but I need a good year to get stretched out so I don't pull something trying to help the kids learn to skate. I have visions of my dear Father, trying to avoid a wild 4 year old, as well as a hazard marked with cones, and then slipping on a "slippery spot on the ice" nearly made himself a wish bone. Actually, maybe kids learn faster if they just go out there by themselves and figure it out. That sounds good, maybe I can watch the baby and keep the hot chocolate company or something.
This month I am back to the land of general surgery, which is nice, actually. My first day on was Thursday, and I was on call. I got to take out two gallbladders with an attending I have barely met, and the second one he let me do practically the entire thing. I helped put in the gas port and then put in two ports on my own, and held the gall bladder for him while we did cholangiograms (injecting the cystic duct to image the bile ducts and confirm we have the correct duct, as well as look at the specific anatomy (there are plenty of variations to the "normal" bile duct anatomy).
After this point, we started the actual operation and he let me operate the camera as well as do the dissection, isolate and clip off the duct and artery, cut them, and then use cautery to dissect out the gallbladder itself and then put it in a bag and pull it out, followed by careful inspection for bleeding or oozing and then irrigation and quick inspection of the bowel and then taking out and suturing up the port holes.
It was my first real abdominal operation where I was the primary operator, and it was great. Helps to confirm to me why I am here and what I am trying to get out of it.
Well, that is about it for this time. We left the sledding hill just perfectly: everyone had a good time and was upset to leave. Maybe we will let mom go back with them tonight and sled again while I keep the baby and Anne company here in the warm house.

I looked up the park website and there are at least 4 parks here that have sledding hills, and 3 that have ice skating ponds. Fun times.

Dr. Meat

From February 2007

January

From January 07

January was busy.

Starting off we had vacation the first week of January, where my dad and Maria came out for two weeks and were a tremendous asset to us with a new baby and three other children. God knew we needed them here, because one of the first days back to work, my dad came and told me at about 6am that the basement was flooded. Seems the roots are growing into our sewer and with the extra rain we had, our drain couldn't keep up and we backed up. Had to tear out half of the carpet, rip up the pad and then my dad bleached everything and we set it out to dry.
Insurance had a carpet guy come out and he sprayed some cleaner into everything and then re-laid the carpet. Next, a cleaner service comes to actually clean the stuff, and then I have to figure out what to do in the office as we threw that carpet out and are not sure what to replace it with...

So, I have no office to work from or be inspired to blog from, which is fine because we have been busy this month with work (I have been on Urology) and sickness. All of the kids have been sick this month, Kristi included. Mary Beth is now out here with us for two weeks and she is sick too. She was well on her way to recovering from a nasty bug when she arrived and I think that we have succeded in giving her a little too much to do. More than we intended, anyway. Last weekend we were in the Children's Hospital for Friday night through Sunday afternoon with Pati, who had RSV bronchiolitis and was having a very difficult time managing secretions. Mary Beth held down the fort with the three sick bigger kids for the whole weekend while we parents were at the hospital. We don't know what we would have done without her.

All is now well, and we even have our recycling trash bin here. The city just distributed new trash cans to us, well, about 4 months ago, and we finally have the special one for recycling so we can save the planet. Phew! sure feels better now.

Urology has been pretty fun. If you like genitals and their pathology. Actually, I like the bladder scopes, and after the second week I was doing scoping people's bladders and shooting dye in their ureters and laser blasting kidney stones with a vengence. Pretty fun, and they make a killing and have a good life, to boot, but there is something that tells me I would grow to hate it, and being so focused on a single organ system would drive me nuts and make me wonder why in the world I got into medicine, anyway. Nice to know that.

Actually, one of the residents a year ahead of me just switched to Urology, so next year he will be an intern again and start all over. Good for him, but bad for us because he is such a good surgeon and guy. Oh well, I hope they find a good replacement, since he and I were supposed to be senior and chief residents together. I am just trusting God for the replacement.

No new pictures at the moment, since my hard drive is tucked away out of water's reach and all of my pictures are on that drive... .Also because I just finished taking my annual American Board of Surgery In Training Examination today. This is a yearly exam we take which is sort of like a "see where you compare with all of the other surgery residents in the country" as well as a "better study more or else we won't let you pass on to the next level" whip.

I will see if I get a chance to throw some pictures up for you all. Since it has been colder and snowy lately, we have not been taking that many pictures, but we will see what we can do.

Hope all is well with you and the new year brings closeness with Him.

David